Efficacy and safety of acupuncture for chemotherapy-induced diarrhea in colorectal cancer patients: a protocol for a systematic review and meta-analysis

BACKGROUND: Chemotherapy-induced diarrhea (CID) is a common complication among colorectal cancer patients receiving chemotherapeutic treatment. This condition adversely affects therapeutic outcomes and potentially increases mortality risks. Acupuncture, an integral component of traditional Chinese medicine, has gained widespread use in China's clinical settings. Recent findings suggest that this non-drug approach may provide therapeutic advantages for managing CID. This warrants further research into its clinical application. METHODS: A comprehensive systematic review will be performed to find randomized controlled trials (RCTs) that examine the therapeutic effectiveness and safety of acupuncture treatments for managing CID in patients with colorectal cancer. The search strategy includes eight major electronic repositories: PubMed, Web of Science, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Biomedical Database (CBM), and China Scientific Journal Database (VIP), with no language restrictions. Primary endpoints focused on clinical improvements quantified through two key parameters: alterations in diarrhea severity according to the Irritable Bowel Syndrome Severity Scoring System (IBS-SSS) classifications, and modifications in episode duration. Secondary endpoints encompassed safety assessments of acupuncture-related adverse reactions and comprehensive evaluation of quality-of-life indicators using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Two reviewers will independently assess the risk of bias for all primary outcomes via the Cochrane Risk of Bias tool (RoB2). Disagreements will be resolved through discussion or third-party adjudication. For data synthesis and meta-analysis, all statistical analyses will utilize Review Manager software version 5.3 from the Cochrane Collaboration. CONCLUSION: This systematic review will synthesize existing evidence to evaluate the therapeutic efficacy and safety of acupuncture in managing CID among colorectal cancer patients. The findings aim to inform clinical practice by assessing whether acupuncture represents a viable adjunctive therapy within evidence-based treatment protocols. SYSTEMATIC TRIAL REGISTRATION: PROSPERO CRD420251045610.